You’re Probably Eating More Ultra-Processed Foods Than You Think
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From KQED in San Francisco, I'm Alexis Madrigal. Here's a wild fact: more than half the calories that Americans consume comes in the form of ultra-processed foods, a category that's emerged over the last couple of decades to denote foods that are basically only created by industrial food companies.

In the last couple of years, a variety of health conditions have been linked to diets high in these kinds of additive-rich foods, in addition to their role in the obesity epidemic. The question is, are these foods really categorically different from other things Americans eat? Is it just they're sugary and salty and fatty, or does the actual processing, the technology of it, really matter? We'll talk about it all. That's coming up next, right after this news. Welcome to Forum. I'm Alexis Madrigal.

It's fascinating to stroll through the aisles of the grocery store, any grocery store, and realize that even similar foods on the shelves have crucial differences in the amount of processing that's gone into creating them. One yogurt might have all ingredients you could produce in your own kitchen, while the one right next to it might be filled with industrial additives. Same goes for frozen pizzas and peanut butter and cereals and a whole bunch of other stuff.

And though there is some controversy, increasingly scientists studying how Americans eat think that there might be something about the ultra-processed foods that's doing something unexpected to our bodies and maybe even our minds. Here to talk about these foods, what they might mean for our health, and how to spot them on grocery store shelves, we're joined by Alice Callahan, nutrition reporter with The New York Times. Welcome, Alice.

Hi, thanks so much. It's great to be here. Yeah. We're also joined by Dr. Uma Naidoo, who's a psychiatrist, a chef, nutritionist, and author of the books, This Is Your Brain on Food and Calm Your Mind with Food. Welcome. Oh, thanks for having me. Yeah.

We're also joined by Laurel Bristow, host of Health Wanted on WABE Public Radio in Atlanta and NPR. She's also Associate Director of Audience Development for the Rollins School of Public Health at Emory. Welcome. Thank you so much for having me. So before we get into and pass judgment on ultra-processed foods, or UPFs, people may see that abbreviation, Alice, talk to us about how an ultra-processed food is defined. Yeah.

It's a great question, and it's one that honestly scientists are still grappling with and debating. But the current definition that's used by most researchers in this field is based on the NOVA classification system.

And essentially, this says that an ultra processed food contains ingredients that you wouldn't have in your home kitchen, like you probably couldn't purchase at the grocery store. And the reason why this is sort of the operational definition of an ultra processed food is that

You can actually look at the label of a food and know how it was processed. But you can look at the ingredient list. And if you see these kind of more industrial ingredients that you don't recognize, those are like markers that this is a food, you know, that was intentionally developed by a food company for production at kind of an industrial scale. And so those kinds of ingredients are like guar gum or like red dye five or whatever. That would be the kind of thing we're talking about?

Exactly. Or things like, you know, protein isolates, modified cornstarch, any kind of like non-sugar sweeteners, that kind of thing. They're ingredients commonly used in food industry, but we don't really cook with them very often. So a single, let's say you have a peanut butter that's like moldy.

like mostly peanuts and salt or whatever, if it has something added to it from this industrial cabinet, then it becomes an ultra-processed food, even if, like, largely it was just made from crushing peanuts up.

That's exactly right. So you end up with, you know, I think the scientists who developed this definition, they knew that they were going to have to draw lines somewhere, right? So it is a very broad definition. You end up with a huge range of

products that are classified as ultra processed foods from like Twinkies to, you know, what we might normally consider like a really wholesome whole grain bread, but it has say like one emulsifier in it that gives it this like spongier texture or something. And those would all be classified as ultra processed foods. So I think that's a really important point that there are a lot of foods in this category. We really, you know, we can talk more about

what the science says and what we do know, but what we, we don't know for sure that everything in this category is bad for us. So I really don't want people to equate ultra processed food as being, you know, harmful. Um, we're still trying to sort out those details. Dave's killer bread, for example, would fall into this category because it has, uh, you know, enzymes is the, is a particular ingredient there. Um, Laurel Bristow, I mean,

Ultra processed foods are clearly not something new. People in the United States have identified, you know, food processing as being, you know, kind of a core part of how Americans eat. Right. That these foods have swept into grocery store shelves and into our diets. Why has that been the case? You know, it seems like this American diet is particularly highly processed. Why is that?

Yeah, I mean, I think a lot of that has to do with our reliance or the way that we have supported and built up kind of the industrial farming complex in this country. I think that we have spent a lot of time or our governments have spent a lot of time and subsidies to support, you know, these big farmers who then these products become very cheap to make foods with. And you can mass produce foods that are shelf stable for a really long time. And it's stuff within this processing that we are investigating as potential

potentially contributing to the poor health outcomes? You know, is it that we have these mass-produced shelf-stable things that have lower water content and so they're higher in calories and so people are getting more calories from these? So I think the farming practices in this country moving away from small local farms and more into concentrated subsidized farms that then produce ingredients that are very cheap for food companies to make their foods with.

is a huge contributing factor to the way we have shaped the American diet. So this would be like corn syrup. Yeah. What would another one of those be?

I think, you know, we have a lot of subsidies for grain industry, for wheat and that sort of thing. So we have kind of carbohydrate high diets these days. Dr. Naimu, I mean, when for you did ultra processed foods become a concern and what are your main concerns about them?

Yeah, thanks for that question. You know, my main concern is that, to the points that my colleagues are mentioning here, the average person shopping in the supermarket doesn't necessarily know the differences in these definitions. And I think more education toward the public is key in that way. My biggest concern is that there is this connection between the food we eat and our mental well-being. And COVID really uncovered a mental health crisis in the

So any option that we have, since we eat meals and we probably eat several meals a day,

Food becomes very critical in the management of our health and wellness, but also our brain health and our emotional well-being. So things like our mood or levels of anxiety. Anxiety increased by 25% during COVID. And that's been reported in a really reliable journal called The Lancet. So my biggest concern is that

Being able to understand what a whole food is versus a processed or ultra-processed version of it becomes helpful to us to understand things we need to step back from a little bit. Because if not, there's a reason that the Western diet, the standard American diet, is also called the SAB diet. And I think that people are suffering from that as well. Yeah.

What would the mechanism be connecting these foods that we might be eating more than, you know, in other places with the mental health of people?

One of the ways that we are learning and research is ongoing in this area, but it's no longer soft science, is that there is a connection between the gut and the brain. And we know that about 90 to 95% of serotonin receptors and actual serotonin is in the gut area.

The gut also has trillions of microbes that have multiple functions and they actually help to take care of our health if they are taken care of. So these trillions of microbes, if they are fed by the food that we eat and if we are nourishing them with healthy whole foods and, you know, beans, seeds, legumes, healthy proteins, etc.,

whichever source you may prefer, then they are well taken care of and they can function at their peak and they take care of, you know, from things like immunity to sleep and circadian rhythm, which is our internal body clock, to mental well-being infection and more, infections and more. But if we feed them with ultra-processed foods which are not

containing many healthy ingredients. In fact, more often they're containing ingredients that are disruptive to the gut environment. What happens is that they start to

really create toxic breakdown products from these ultra-processed foods. And this starts to create inflammation in the gut. Once you start to set up inflammation in the gut, because the gut and brain are connected, you start over time to develop inflammation in the brain. And there's a real correlation between seeing an uptick of symptoms, either mood-related or anxiety are the most common, but other symptoms as well.

that you see clinically. And that's the concern with just continuing on

or continuing to only eat these types of foods. We understand someone may eat them and have them as part of their diet, but it shouldn't be something we are relying on for our main source of foods. Because I guess the idea is that some of these ingredients at least sort of derange the gut microbiome. I mean, that's essentially like the core mechanism.

Yes, they are disruptive to the gut microbiome and they drive the breakdown products being more toxic to the environment of the gut, causing inflammation. That's certainly one of the mechanisms that's been researched and one of the mechanisms that we understand. Yeah. And are there particular ingredients in this fairly wide set of things, you know, chemicals that are industrial additives to food that seem like they're particularly to blame for this?

I would refer back to the ingredients that Alice mentioned because I usually say to my patients, if you don't recognize this ingredient, for example, people are more savvy now about colorants, dyes, et cetera. But if you don't recognize a big word on a food label, it's probably not a whole food and it's probably not the healthiest one for you. What we do know is that these ingredients

sort of ingredients in ultra-processed foods are damaging to the gut, and they definitely impact those trillions of microbes that really function to help our health if we are nurturing them with healthy whole foods.

It's just fascinating, too, how much research has come out about the gut microbiome and changes to it. And people have been trying to do these comparative studies between cultures and cuisines and countries. It's just totally fascinating. We're talking about the rise of ultra-processed foods, what they might mean for our health, and how to spot them on grocery store shelves. We're joined by Dr. Uma Naidoo, a psychiatrist, chef, nutritionist, and author of This Is Your Brain on Food,

Also joined by Alice Callahan, nutrition reporter with The New York Times, and Laurel Bristow, who's host of Health Wanted on WABE Public Radio in Atlanta.

What do you eat from you? What kinds of ultra processed foods do you eat? What are your questions about this category of stuff on the shelves? You can give us a call. The number is 866-733-6786. That's 866-733-6786. The

Email, you know it. It's forum at kqed.org. Social media, Blue Sky, Instagram, et cetera. We're KQED Forum, and there is the Discord community. I'm Alexis Madrigal. Stay tuned for more right after the break. We could all use a little help navigating the news these days. The Consider This podcast wants to give you a hand. Six days a week, we'll help you make sense of the day's biggest news story and what it means for you in less than 15 minutes. Listen now to the Consider This podcast from NPR.

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Welcome back to Forum. I'm Alexis Madrigal. We're talking about the rise of ultra-processed foods. Joined by the host of Health Wanted, Laurel Bristow, Dr. Uma Naidoo, a psychiatrist and nutritionist, as well as the New York Times' Alice Callahan. You know, Alice, I wanted to ask you about the technology

times challenge, right? You've got this little game where you go through the grocery store, virtual grocery store shelves, and you try and, you know, spot which products are ultra processed. One of the things I found really fascinating about it is how very similar products sometimes are ultra processed and sometimes not. Like what things that you would think would be exactly the same, like two types of Greek yogurt or something.

Yeah, that's exactly right. So that was kind of the point of doing this interactive game, the grocery shopping game, was to really kind of

put people to the test. You know, can you look at food labels and figure out what would be classified as ultra-processed and what would not be classified as ultra-processed? And it is not always easy to tell. Even for me, you know, I've been reporting on this for a long time. There are still ingredients that I'm sort of like not super familiar with.

And, yeah, it's tricky to tell. And within any one category, you can often find examples of both processed, I mean, ultra-processed and not ultra-processed things. Like we had a frozen pizza example, for example. Yeah, that was a really good one. Yeah. Two of the products were not ultra-processed. And, you know, the other two were. And you might not guess that standing in front of the freezer case. So it really requires some careful label reading. Yeah.

Laurel, how do you think people should be approaching their intake of ultra processed foods?

I mean, it's such a hard thing to do because, you know, it's estimated 70% of the food supply is ultra processed foods at this point, and that makes up to 50 to 60% of people's diets higher in adolescence. And so I think it is a good idea that you're not only trying to limit the ultra processed foods that you're taking in, but increase the kind of foods and the nutrients that people are lacking. Only 5% of Americans are hitting their fiber goals. So I think it's

an important thing to look at the balance of your diet in a day-to-day basis and to try to make those adjustments where it's possible because we really have structured our whole lives around ultra processed foods. So I don't think people should feel too much guilt if it's a lot harder than they thought it would be to remove those from their lives.

You know, one of the areas where I feel like this exact topic first really came into the political light was sort of around beverages and sodas. Mike writes in to say, you know, I think it's fair to mention the beverage industry is now notoriously ultra-processed as well as with the added chemicals. I cannot even pronounce ingredients in so-called healthy sports drinks or protein shakes. And one of the things I'm really curious about is it seems like people got the message from

maybe soda is not so great for you. And at the same time, shifted into all these other kind of sports drinks and other things that our listener was mentioning, which are functionally the same thing, right? Well, yeah, that's a really interesting point is that I think when we change labeling, like the FDA has just made a recommendation for labeling foods based on, you know, how much sodium or fat or carbohydrates it has. And one of the concerns is kind of with soda,

the same thing that happened with sodas is that you change the messaging around something and these food companies will kind of just change how they're processed and you could potentially have the unintended consequence of, you know, they changed the ingredients so it's not these things we know to be bad, but they're putting something different. They've just created a new system to put in there. And so with the soda example, I think it's a fair point. I think we get really entrenched in what is

The idea that something is bad and then we might accidentally end up doing something worse to ourselves. Or at least like that the food companies figure out like, well, OK, that brand of that is a little off. OK, we'll be over here doing this other very similar thing with a different brand that, you know, is attractive. Yeah, absolutely. Let's bring in Lillian in San Francisco. Welcome.

Hi, thanks for taking my call. I'm excited you guys are doing this. This is my New Year's resolution is to get my family on the right path nutrition-wise and ultra-processed foods are one topic that's a little overwhelming. And specifically, I have a question about bread. When you guys said that Dave's Killer had ultra-processed foods, I was kind of shocked.

Wondering if you have any suggestions. I mean, that's something I'm putting in my toddler's lunchbox every day and we're eating every day. And it's delicious. And yeah, people love it. I mean, there's a reason it's like half the grocery store. Yeah.

Yeah. Like, is there a bread that is not ultra processed? That's not sourdough? You know, do you have any suggestions for resources for parents of picky eaters? Yeah, well, of course, Lillian, you should be making all of your breads from home from scratch is what I was thinking. Alice, what would you say? I mean, this is this does show up in your interactive feed.

Yes. And I am a parent, too. So I am right there with you. And so with breads, it's very hard to find a packaged bread that's not ultra processed. It doesn't have one of these ingredients that sort of flags it as ultra processed. So two things. One is that when researchers research.

try to sort this large category of foods and identify which ultra processed foods are most strongly linked with poor health and which ones are not and

especially whole grain breads and whole grain breakfast cereals actually shake out to look really good. Like some ultra processed, like the sugary drinks and ultra processed meats, those very clearly have been shown time and time again. Ultra processed are not like,

Those are not good for us, right? But things like whole grain bread, yogurts, you know, even if they're ultra processed, are actually not linked to poorer health outcomes. They're linked to better health outcomes. So this is an example where I think we have to be really careful about painting things with too broad a brush. So, like, I do think...

you know, maybe marginally fresh made bakery bread is better for you. But I don't think it's too much of a compromise to choose, you know, a whole grain bread that, you know, pay attention to the ingredients. Look for one that doesn't have a ton of things you don't recognize. But for me personally, you know, it's hard to

Kids like that soft sandwich bread. Right. I mean, that's why they add that's why most of the breads have this stuff. Right. It's like the squishiness factor. Yeah, exactly. So, you know, I think we just don't have enough. We don't really have evidence to say that that bread is harmful. And I don't you know, I think we have to be careful that people don't overreact because, you know, most people don't consume, as we already said, don't consume enough fiber, don't get enough whole grains. And so, you know, a whole grain bread is.

is a really versatile way to get those important nutrients. And we don't want to throw out everything else we know about nutrition over the alarm, over ultra-processed foods. Also, Lillian, I wanted to direct your attention to a show we did called How the Other Half Eats from a few years back.

So as part of your, you know, New Year's resolution, I feel like one of the lessons of that book is like no one thinks they're doing it right. You know, and that seems to drive a lot of things for people feeling like they're all doing it wrong. Anyway, thank you so much for the call. Let's go to Lucy in San Francisco. Welcome.

Hi, thanks for taking the call. So my daughter was one of those caught up in the teen mental health crisis that was kind of exploded past COVID. And we've been what's kind of typically called the picky eater. And so while I know that it's a combination of, you know, biology and environment, these things, and there's a lot of factors, including social media, et cetera. I'm curious,

to know from Dr. Naidoo, is there a way of telling about a test besides maybe a blood test about gut health and whether or not these microbes are affecting her moods and her brain? And then beyond that, is a better diet and better nutrition going to kind of, along with therapy and medication, is a better diet going to help her improve as she matures? Lucy, what a good question. Dr. Naidoo?

Yeah, of course. So I definitely believe, I think, and it's backed up by the research that

adjusting and improving her diet, depending on what she's eating, can improve and help her mental health over time, along with whatever else she might be doing, which may include therapy, medications, or anything else. So this type of guidance is always something to be discussed with the physician who's taking care of her or the prescriber taking care of her. But food can be hugely impactful, and any

and steady changes that she can make will definitely be helpful for her mental well-being. I think that, you know, there are three tips that I like to define for people because it's just easy to remember. And the mnemonic is SAW, S-A-W.

swap, add and walk. And swap is basically asking people to chunk it down into just one food that they know or you as her mom might know is a problem. Maybe it's soda, maybe it's a certain snack or candy or something that is relatively unhealthy that you'd prefer for her to cut back on and swapping that out with a healthy version, even if that one thing is something you make at home, is a good idea.

a good way to get started. Then adding in those vegetables, because we know Americans are terribly lacking in the fiber in their diet. Vegetables, fruit, beans, nuts, seeds, legumes, and healthy whole grains are ways to easily get that in. So adding in, maybe it's protein. There's a lot of talk about the amount of protein. So adding in some protein sources that are clean sources of protein are a good idea. And the W for walk is really adding in any form of exercise or movement, because you're

Not only do we know that the actual movement improves mood and lowers anxiety, and that's been borne out in research, but these are healthy habits to build as part of a healthier lifestyle. So whether it's engaging in sport at school or outside of school activities, these are really key. But they also involve things like mindfulness, meditation, yoga, a practice that may help

to actually calm the mind, including breathwork exercise. So sort of a broad category, but to give people a starting point to see if there are ways that they can feel better. Yeah, very nice. Let's bring in Rob in San Francisco. Welcome, Rob. Hi.

Thank you. Comment and a question. The comment is we've had a son with food allergies growing up, so we got in the habit of reading food labels pretty religiously and noticed that some of the big companies are now starting to take those things out of their foods, like Cheerios used to be full of a lot of processed stuff and dyes.

And now you get the fruit Cheerios and they're all plant-based colorings. And I think that the general public has waken up to the fact that a lot of this food additive stuff is bad for us and they're just not buying it and the companies are listening. So that's,

my comment and then my question is what do you think about this new recent movement of going from like the now they're calling it evil seed oils to going back to like regular fat like bacon grease you can buy it in a tub now um lard is coming back butter is coming back you know people are saying these are better for us healthier for us than all these

Previously touted healthy. Right. Your safflowers, your sunflowers. Yeah. Well, yeah. Let's take that to Laura. I mean, Laura, I mean, I bring it to you largely because, you know, those seed oils are tied, obviously, to big ag, etc.,

Yeah, I mean, seed oils is this hot topic that there really is not the data to support that they are as evil as they are being presented to be. We know that diets high in animal fats are bad for your cardiovascular health. Like we just that is something that has been so clearly established. You know, we know that diets high in protein.

artificial trans fats are bad. That's one area that we've actually been able to regulate them out of our diets in terms of added trans fats. So I just think this movement against seed oils is

fueled by social media, I think largely, because it is appealing to people to be able to pick something to blame the majority of their health problems on. And the data currently just does not support that that is actually the case. Really interesting. Alice, a question for you from listener Amy writes in to say, how much consumption of sugar alcohols is okay? And also a question for you from host Alexis, which is what are sugar alcohols?

Okay, great. So let's see. So sugar alcohols are used to sweeten foods and they're not sugar and they're also not alcohol, but they are kind of in that class of non-sugar sweeteners. I don't have an amount off the top of my head that is considered safe to consume, but this is an example of a type of ingredient where people can have very

sensitivities to them. For a lot of people, sugar alcohols cause GI symptoms, you know, things like bloating, diarrhea, a lot of uncomfortable symptoms. And you may know if you're one of those people and you may not be able to tolerate very much of them at all. So that's an example of, you

you know, an ingredient where for a lot of people, it may be no problem. For some people, they might really feel the effects of that ingredient and want to learn to identify them on labels and steer clear of them. And, you know, I think these sugar substitutes as a

We don't have a ton of research on how they affect things like the microbiome, for example, or gut microbiomes and where the, you know, the lining of our guts, that kind of thing. And it's an area where I think we need a lot more science so that we can understand how these different additives are affecting our health. I mean, Alice, I think one of the things that I have taken away from getting ready for the show is that the science

There's so many different things to research, right? I mean, there's the idea of the overall ultra-processed, food-rich diet that people eat out in the wild, like in the world. But then there's also each of these individual ingredients which food companies are coming up with. Then there's the interactions between those things. And then there's

The ways that those, you know, the mind and body stuff that Dr. Naidoo has been talking about. If people want to stay in this and kind of follow this research, like what are the promising things for them to kind of look at?

In the ultra processed food. Yeah, yeah, yeah. Like, I mean, if you had to guess where the sort of action is, like what what's actually important, like these some set of specific ingredients, the overall amount of ultra processed foods, the fact that these things kind of set your mind up to expect everything to be delicious. And so you end up eating too much of them. Like what what do you where do you think the actual kind of research is going to come into focus?

Yeah, there are a few areas that I'm watching really closely. One of them is just that we have a ton of studies on ultra processed foods that tell us, that give us correlations between diets, high and ultra processed foods, and a range of poor health outcomes.

We have not established causality for all of those things, right? And that's very hard to do in nutrition research. Our diets are very complex. You can't just lock people up and ask them to consume only ultra-processed foods for the decade that it takes to develop cancer, cardiovascular disease. So we really have to look at this area from different angles and use different research methods.

So one thing we need more of are clinical trials. And we have a few clinical trials on ultra-processed foods. So this is where, you know, people sign up to do a study. They come in and ideally they live, you know, at the research lab. Like NIH. Yeah, exactly. And their diets are totally controlled. Those studies have to be shorter. You know, you can't track someone for years and years. But you can look, for example, at diabetes.

calorie consumption, calorie intake, and weight gain. And so that's one of the areas where we have some data and we're getting more is that, you know, we know when people are

given meals that are predominantly ultra ultra processed, they eat more calories without even realizing it, without feeling more full or more satisfied. They eat 500 to 800 more calories per day, which is stunning. You know, and it's when you see that data, you're like, wow, you

you know, that could explain a lot about, you know, the rise in obesity in this country. It's like you, you can't just eat one taken to like the societal scale, right? I mean, it's like, yeah, yeah, yeah, exactly. So, um, so, you know, I think we, there are more clinical trials happening, you know, like that where they're looking at changes in microbiome inflammation, um, and,

And I think that will give us a much better grasp of this question of like, what are the causes and what are the mechanisms here?

So that's an important area. Great. Well, let's hold the rest. We are talking about the rise of ultra-processed foods, what they may mean for our health with the New York Times' Alice Callahan, psychiatrist and nutritionist Dr. Uma Naidoo, and Laurel Bristow, who's host of Health Wanted on WABE Public Radio in Atlanta. We're going to get to more of your calls and comments when we get back from the break. I'm Alexis Madrigal. Stay tuned.

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Welcome back to Forum. I'm Alexis Madrigal. We're talking about ultra-processed foods, how to spot them on grocery shelves, what they might mean for our health, mental and physical. Joined by Dr. Uma Naidoo, who's a psychiatrist, chef and nutritionist. Her books are This Is Your Brain on Food and Calm Your Mind with Food. Joined by Laurel Bristow, who's host of Health Wanted on WABE Public Radio in Atlanta, and Alice Callahan, nutrition reporter with The New York Times. Of course,

We're taking your calls, taking your comments. A couple of recommendations from listeners before we go back to the phones. One listener writes, I recommend reading the book Decolonize Your Diet that not only provides great recipes for Mexican food, but explains how to understand ancestral foods and how easy to cook and nutritious they are. Another book I like is Plant-Based on a Budget. Once you understand ingredients more, you seek them out and appreciate them more. I actually like Decolonize Your Diet quite a bit too. Georgianne writes,

Check out the multiple ingredients and salad dressing. So much of it is ultra-processed. And we all think that eating salads is a good thing, right? Making your own vinaigrette couldn't be easier. Here it is, Georgeann's recipe. Three parts vinegar or lemon juice, one part Dijon mustard, five parts olive oil. Done. I'd add some salt, but okay. Let's bring in Deborah Sue in Berkeley. Welcome. Hey.

Good morning. It's such a nice thing to hear this topic, and I've been reading the New York Times Science Section articles on it, so this is awesome. I'm a health practitioner in Berkeley, and I just want to make sure we don't demonize every food because something like guar gum is a soluble fiber. It helps feed the prebiotic. It is a prebiotic. It feeds the gut microbiome. So you might see that in a product, but I don't think they're all bad. Sometimes we supplement with it to exactly help the

the gut microbiome. I don't use it exclusively on its own, but I think there's a lot of foods that we are, like we say, we don't have enough information or understand, but,

We all need our fruits and our vegetables and our polyphenols, our red, our blue, our purple foods to help feed the microbiome diversity and short chain fatty acids. But the guar gum piece has a place. I just love Dr. Naidoo to speak to that because I love what she was saying about everything. Yeah. Thanks so much, Dr. Naidoo. And it's always interesting to think of yourself as an ecosystem that must be fed by all these different things. But that's really what we are. Dr. Naidoo?

Yeah, I think you make a great point. And I think that what we don't want to do, and I think what we want to be careful about is not demonizing any one ingredient. I just want to refer back to a couple of points to kind of heighten what I'm saying. So I think that you're right about wargum as an actual ingredient. But I think that where we get lost is the amount that is in the different foods and then the amount of that food that we might consume. So I think it goes back to my point I made earlier in this show about just understanding

helping people get a little bit more knowledgeable about food labels and what they're looking for and the things to be more cautious about. Same thing with sugar alcohols. You know, there are a lot of foods that contain these

And actually, it's a pretty good and solid body of research around the impact of the microbiome. But at the same time, we don't have to say to people, never, ever put a little bit of stevia in your coffee or your tea. It's modulate and moderate the amount that you're doing so that that way people have a choice. But they're not, for example, drinking a diet soda every single day or several times a day, which is very different.

So it does depend on the ingredient. But for example, the conversation about bread, I want to make this point. One of the things that is the concern around things like cereals or bread, and by cereal, I mean the ultra processed version of cereal using the method of extrusion, which is how many cereals are made. And there are healthy cereal companies on the market as well.

The concern here is that these ultra-refined grains have a massive impact on our blood glucose level. So they cause spikes in our blood glucose, they impact our insulin resistance over time. But there are ways that from

When you're able to find a healthy bread that works for you and your family, the research has shown that freezing bread can lower its glycemic index. And this study was published in the European Journal of Clinical Nutrition. If you freeze the bread and then toast it, it actually lowers the glycemic index, which is what you're trying to do.

When you are trying to choose a healthier bread, we need the whole grains. But at the same time, the refined grains in those breads actually spike our glucose levels. So finding those little tricks and tweaks that you can do become really helpful. So this particular study showed a lowering of the glycemic index, and that's been replicated in other studies as well. So I think, you know, I think.

having an understanding of what the ingredient is, using it in moderation. Same thing with seed oils. There is actually an ongoing body of evidence about them, but it's understanding the ratio of omega-6 fats and omega-3 fats. It's understanding that you can use a small amount of these

But some of what you said earlier about, say, the revision of butter is fat kind of idea and these types of fats are healthy. Some of that has been how the food industry has really engineered what has been sold to the public. So there was a low fat craze earlier on and decades ago. And that led to the fat being removed and carbohydrates being added in to actually produce

change the flavor of foods. So I think that what people are trying to do is understand what should they use and what shouldn't they use. So

You can use it in moderation. My favorite healthier fats are avocado oil, olive oil, a little bit of butter or ghee, clarified butter. So some of those, but I use it in moderation. I don't use it in everything all the time. And I think that that's an important caveat when it comes to any of these ingredients, because I agree with my colleagues on this discussion.

There's an ongoing body of research. We may not be at a finite point of knowing, but I think it's important to guide people about choices they can make. So a little bit of something is okay. Don't consume it all the time and don't make it the sort of the sole source of what you're eating. And that's what I'm certainly trying to say about ultra processed foods. Got it.

Let's bring in Doug in San Francisco with some questions on the research. Welcome. Hey, Doug, can you hear me? Oh, yeah, go ahead.

Hi, yeah. So I have a question about how much of the research on ultra-processed foods' health effects is actually causal. And I think you touched on this earlier when I was actually saying my question. But an example of this is, you know, we used to think that, I get recommendations that red wine was good for heart health. And then it's now, we're now taught to think that, you know,

You know people of higher socioeconomic status have differences in their diet They drink more red wine versus liquor like beer and that you know alcohol in general is bad for you And that's just the difference in the kinds of things that people consume and

How much how much kind of causal evidence do we have on ultra positive? Yeah, man, Doug, I find this one totally fascinating as well. You know, Alice, just because we were talking about it earlier, I'm going to send this to you. I mean, it's pretty hard to study that. Yeah. I mean, tell me more about how people are trying to do it. Yeah, I think it's a great question and it is very difficult to study. Yeah.

But yeah, in order to establish causality, you do need these clinical trials where you test people, you know, with ultra processed diets and non ultra processed diets and look at direct effects. And so we need more research on that. I say I would say we have, you know, kind of accumulating evidence on the calorie consumption piece and.

which certainly could drive, you know, if it's just easier to overeat ultra-processed foods, then that could certainly drive some of the chronic diseases that we see associated with ultra-processed foods like cardiovascular disease and type 2 diabetes.

um, as well as obesity. Um, but that's not going to give us the whole story. So, you know, like I said earlier, we need to look at these different outcomes. How does the gut change? You know, how does inflammation in the body change? Um, and then, you know, even doing these more kind of lab-based studies, um,

will allow like animal research or in cell culture, you know, can allow us to understand individual ingredients better as well and help to establish causality. But it is like nutrition research is notoriously challenging. One of the concerns with the observational research, which

shows associations but can't establish causality is that, you know, we know there are so many factors that influence how people eat. It's what foods do you have access to? What is your budget? How much time do you have to cook? And so there is a concern that, you know, that we have these confounding factors that people who are consuming more ultra-processed foods might have other factors working against them.

Yeah. And so it's hard to tease that out. And, you know, there are research, there's statistical methods you try to account for all that, but that's why we need different types of research. And, you know, I think this is an area where we do need more investment and funding so scientists can tease this out. And a lot of research and nutrition has been funded by food companies as well. And we really need to see independent federally funded research on this question. You know,

You know, Laurel, Alice touched briefly on the concept of access, access to healthier foods. And I think it's just one of the really tricky questions of whether or not these foods are healthy or unhealthy. Increasing access to things we know are healthy food seems like it's at least a first step, right? Yeah, absolutely. I mean, I think...

It's really important, like we were kind of talking about, you know, it could be that there are these calories that you're getting from this ultra processed food. And for a lot of people, that is the majority of their calories, you know, could be because of marketing, could be because of ease, but also just because of access. And so I think it's really important that we rethink the way that people have access to foods that are good. You know, there was the question about food.

how much of the research is causal. And Alice was pointing out it's really hard to get causal relationships, but we know enough to know that it's a good idea to reduce your consumption of ultra-processed foods, right? Be it from the calories or from the ingredients, we're not totally sure about that yet. But if you can, you know, fill out your diet with whole foods, that's important. So I think we need things like, you know, subsidies for fruits and vegetables in the country to make those cheaper and encourage people to grow them and have better access to those things.

We need to increase access to supermarkets or co-ops or places where people can get food that, you know, is perishable so that they're not just eating from a corner store that has prepackaged stuff because that's the closest thing to them. So I think in our conversation about improving our health overall and our diets overall as a country, it shouldn't just be about what we're taking away, but it needs to be a conversation about what we're adding and giving people access to. Yeah.

Do we have evidence, I guess my only worry about that Laurel is, do we have evidence that increasing that access does in fact make people's diets better? Yeah, I mean access is only one part of a big picture. It's about, you know, do people have time to prepare foods that, you know, take more effort to really cook whole meals? You know, do people have the education to know why it's really important to get these things? So I think

The other steps are going to be really important in order to get people to use what is available to them, but if it's not even available to them, then it's kind of harder to make the argument to kind of invest in those resources for the whole picture that we need. Yeah. Let's bring in Jose in Los Gatos. Welcome.

Hi, good morning. My question is simple. Do we have any evidence, either statistical or empirical, about the fact that consuming foods with high probiotic content, such as kefir, can offset the negative impact of highly processed foods, since I believe we can't fully stay away from them nowadays?

Right. That's such a good question. Dr. Naidoo, do you want to try and take this one on?

Sure. So there was a study completed at Stanford University a few years ago that was actually looking at fermented foods. And you mentioned kefir, which is definitely a fermented food. And it happened to show the reduction of inflammation in the gut microbiome as one of the outcomes. And what I would say is that even though, you know, this is all emerging and ongoing science, we do think that one of the ways in which

ultra processed foods. And by that, you know, I think we've spoken during this call about what we mean by the ones we want you to be more cautious about.

versus the novel classification of the different levels of processing. They do affect the gut microbiome. They do drive inflammation in the gut. So the fact that that study I'm making association here did show that fermented foods load inflammation in the gut, I think is significant. So I feel that

It goes back to an earlier answer that I gave. This would be in the add category, right? Exactly, exactly. You know, add in those healthy whole foods because whether it's kefir or kimchi or whatever fermented food you enjoy, those foods can certainly help with not only gut healing but the gut environment and help nurture those microbes that are really helping our health both for our body and our mind. Yeah.

We had a nerve talking about Dave's Killer Bread, so I wanted to bring in Sam in San Francisco with a question about bread. Hey, welcome. Hey, it wasn't really a question. Or a comment. Yeah, go ahead. A person asked about healthy bread. Ezekiel brand. I get it at Trader Joe's or Whole Foods. It's sprouted whole grain bread.

And it has nothing else in it. Also, Trader Joe's has raw almond butter. No salt. That's the only ingredient, almonds. Also, I highly recommend...

Nutrition facts dot org. The guy who runs this site reads every nutritional study, every health study that's published and make short videos or blogs, that kind of thing. Yeah. Hey, Sam, thanks for those recommendations. Really appreciate that. You know, I.

Alice mentioned the federal guidelines or mentioned that, you know, the federal government has a role in regulating these things and in figuring out how to label them and talk about them. How are ultra processed foods showing up in that discussion so that eventually maybe you'll go to the store and, you know, Ezekiel's and Dave's Killer Bread will have a different nutrition label or something?

Yeah, it's a great question. And I think this is one of the reasons I completely agree that, you know, there's a difference between what we take as consumers with like this emerging evidence and how we might look at that and change the way we shop and the way we eat. Right.

versus like how much evidence is required for policy change. And this is where it gets sticky, right? So if you want to put a label on something because it's ultra processed in the United States, that is very difficult to do because food companies will take the government to court if they try to slap a label on something without really solid evidence that it's harmful.

And so, you know, what we are seeing the FDA just yesterday, I think, released their proposed new like front of package nutrition labels that will provide people with if they're if they are passed, if those rules go into place, they will provide people with very clear guidance on whether or not this product is high in sodium, high in added sugars, high in saturated fat.

So those kinds of things still matter, you know, and especially if you see and you can turn a package around and look at the nutrition facts label and see some of that information now. But if you see a food that's ultra processed and plus it's really high in sodium or added sugars, you know, that's also a flag that I think you can use. Yeah.

Yeah, and man, boy, there's a whole debate about the labeling of foods too, right? How effective it is or isn't in some of these cases. We have been talking about the rise of ultra-processed foods, what they might mean for our health, how to spot them on grocery store shelves. You can find out a lot more about them by going to the New York Times. We've had Alice Calhan, nutrition reporter with the Times with us. Thanks so much for joining us.

Thanks. It's great to be here. We've also been joined by Dr. Uma Naidoo, psychiatrist, chef, nutritionist, and author of This Is Your Brain on Food. Thank you for joining us. Thank you so much for having me. We've had Laurel Bristow, host of Health Wanted on WABE Public Radio in Atlanta. Thanks for joining us, Laurel. Thank you so much. I'm Alexis Madrigal. Stay tuned for another hour of Forum Ahead with Mina Kim.

Funds for the production of Forum are provided by the John S. and James L. Knight Foundation, the Generosity Foundation, and the Corporation for Public Broadcasting. We could all use a little help navigating the news these days. The Consider This podcast wants to give you a hand. Six days a week, we'll help you make sense of the day's biggest news story and what it means for you in less than 15 minutes. Listen now to the Consider This podcast from NPR.